Presented by Saudi Commission for Health Specialties
How do you grade the success of the Africa Centres for Disease Control and Prevention more than three years after being granted autonomy from the African Union?
The Pan-African public health agency experienced rapid growth as it stepped up to help coordinate the continent’s response to several emergencies, including COVID-19 and the ongoing mpox outbreak.
And the agency has drawn particular praise for increasing disease surveillance across the continent and working to boost local pharmaceutical manufacturing.
There have been some significant growing pains along the way, though, including concerns about how Africa CDC has spent some of the money it has received. The agency is still dogged by questions around how it is spending a $100 million World Bank grant, which included “immense amounts of funds for travel and meetings,” according to an internal May email from one of Africa CDC’s advisers. The agency says it’s working to improve its spending.
The management style of Africa CDC’s director-general, Dr. Jean Kaseya, has been another fault line. He has been accused of intimidating staff, has warned them against making anonymous complaints, and has made comments during a staff call that were dismissive of mental health concerns. Africa CDC acknowledges Kaseya’s style is “direct and results-focused” but says his leadership is transforming the institution into a world-class organization.
There are also concerns about financial management risks — three staff members were recently dismissed for “acts of misconduct.”
The critiques of the agency come at a delicate moment, though, as questions swirl around its financial sustainability. A recent donor grant report says that of Africa CDC’s 43 grants, 33 have either expired or will by the end of this year. And according to the report, about 40% of the agency’s $99 million in grant funding is tied to expired or expiring grants.
Africa CDC disputes those figures, saying it currently has a $150 million grant portfolio, with $400 million in the pipeline for next year.
It will be hard to assign a grade until there’s more clarity on the institution’s future.
Read: Africa CDC’s rocky road to stability
Amid the panic of the Trump administration taking a sledgehammer to U.S. aid, there has been much diagnosing of what has gone wrong with global health funding. The feedback has been fairly consistent: too many organizations, too many donor-driven mandates, too much overlap, too little alignment with domestic priorities.
This new era of significantly reduced global health financing will force the system to change. The question that still needs to be answered is what that change will look like.
There seems to be a consensus that it needs to look like greater domestic sovereignty, with local leaders and institutions setting priorities and international funders buttressing those ideas. That could also point to a bigger role for regional institutions, such as Africa CDC.
As a first step in any reform, experts underscored the need to reform data systems.
A lot of available data is not current, instead reflecting a reality that is four or five years old. It’s also rarely disaggregated to give a specific picture of what’s going on in groups such as women and girls or adolescents.
Rethinking how and what data is collected could help give governments the insights they need to make informed decisions around their broader priorities.
Read: What’s broken in global health, and how do we fix it?
Plus: Are aid cuts an opportunity to redesign health data systems?
+ More to come: Over the next few weeks, my colleagues and I will be publishing a series of articles that will examine the changing global health architecture — the big ideas floating around and plans to turn such ideas into tangible and hopefully meaningful change. Stay tuned.
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Another result of the cuts to aid by Washington and other donors is that funds to help communities affected by humanitarian emergencies are drying up just as those crises are increasing. That has organizations such as the International Committee of the Red Cross wondering if philanthropists could step in.
Donating to help communities affected by war or climate crises might require some philanthropic players to rethink or expand their mission. But the ICRC and other first responders are running out of options to fund even basic services on the front lines or among displaced communities.
It also doesn’t just have to be funding. There are opportunities for philanthropists to assist with financial and strategic planning and in building connections to other partners who might be able to help address the expanding crises.
Read: Red Cross official calls on philanthropy to assist in crisis zones
Read more: How can philanthropy fund development better? (Pro)
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Speaking of first responders, anyone who has spent any time in sub-Saharan Africa — particularly rural communities — knows that pharmacies are often the first point of care. Strange pain? Nagging cough? No one’s going to an overcrowded health center for those. Instead, they’re checking in to see what the pharmacist recommends.
So why not equip those pharmacies to become more effective health hubs for the communities, Onuh Edoka, the founder of Fedox Pharmacy, asks in an opinion piece for Devex.
It will take some doing, but he can imagine a reality where pharmacists actually get trained to be able to make basic diagnoses, but also have telehealth platforms to connect them with clinicians, who can provide guidance and issue prescriptions. At the same time, countries will need to address the problem of counterfeit medicines as part of a broader formalization process.
Opinion: African pharmacies have potential as the next frontier in primary care
After cuts to U.S. aid led to the closure of more than 400 medical facilities in Afghanistan, local residents describe a spike in the deaths of mothers and newborns, which they believe might have been prevented with medical care. [BBC]
The funding cuts have also devastated tuberculosis services, including diagnostics and treatment, jeopardizing efforts to eradicate the disease and potentially putting millions of lives at risk. [PLOS Global Public Health]
Significant progress in improving women’s health, including reducing the risk of dying during pregnancy or childbirth, is now at risk of being reversed, according to a new report from UN Women. [The Guardian]